scholarly journals Tablet Splitting of a Narrow Therapeutic Index Drug: A Case with Levothyroxine Sodium

2010 ◽  
Vol 11 (3) ◽  
pp. 1359-1367 ◽  
Author(s):  
Rakhi B. Shah ◽  
Jarrod S. Collier ◽  
Vilayat A. Sayeed ◽  
Arthur Bryant ◽  
Muhammad J. Habib ◽  
...  
2015 ◽  
Vol 37 (6) ◽  
pp. 1235-1241 ◽  
Author(s):  
Chia-Lin Chou ◽  
Chia-Chen Hsu ◽  
Chia-Yu Chou ◽  
Tzeng-Ji Chen ◽  
Li-Fang Chou ◽  
...  

2013 ◽  
Vol 61 (9) ◽  
pp. 1586-1591 ◽  
Author(s):  
Joshua J. Gagne ◽  
Jennifer M. Polinski ◽  
Aaron S. Kesselheim ◽  
Niteesh K. Choudhry ◽  
David Hutchins ◽  
...  

2012 ◽  
Vol 25 (4) ◽  
pp. 471-476 ◽  
Author(s):  
Linda M. Tahaineh ◽  
Shadi F. Gharaibeh

Background: Tablet splitting is a common practice for multiple reasons including cost savings; however, it does not necessarily result in weight-uniform half-tablets. Objectives: To determine weight uniformity of half-tablets resulting from splitting 4 products available in the Jordanian market and investigate the effect of tablet characteristics on weight uniformity of half-tablets. Methods: Ten random tablets each of warfarin 5 mg, digoxin 0.25 mg, phenobarbital 30 mg, and prednisolone 5 mg were weighed and split by 6 PharmD students using a knife. The resulting half-tablets were weighed and evaluated for weight uniformity. Other relevant physical characteristics of the 4 products were measured. Results: The average tablet hardness of the sampled tablets ranged from 40.3 N to 68.9 N. Digoxin, phenobarbital, and prednisolone half-tablets failed the weight uniformity test; however, warfarin half-tablets passed. Digoxin, warfarin, and phenobarbital tablets had a score line and warfarin tablets had the deepest score line of 0.81 mm. Conclusion: Splitting warfarin tablets produces weight-uniform half-tablets that may possibly be attributed to the hardness and the presence of a deep score line. Digoxin, phenobarbital, and prednisolone tablet splitting produces highly weight variable half-tablets. This can be of clinical significance in the case of the narrow therapeutic index medication digoxin.


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